Pseudobulbar Affect

Pseudobulbar affect (PBA) is involuntary and uncontrollable episodes of either laughing or crying that seem inappropriate in the social situation. PBA can cause a great deal of distress in social situations, in the work place, and with family.

The emotion is often triggered by something only slightly funny or sad. For example, a sad TV commercial may trigger uncontrollable crying.

The emotion may also be the opposite emotion that the person is feeling. For example, a fit of uncontrollable laughter may be triggered by feelings of intense anger.

Prevalence

Between 43% and 49% of individuals with ALS exhibit PBA. PBA is also found in individuals with stroke, traumatic brain injury, multiple sclerosis, Parkinson’s disease, and Alzheimer’s disease.

Treatment Options

Pharmacological

Nuedexta is currently the only pharmacological treatment approved by the FDA for PBA. Antidepressants, such as amitriptyline, fluoxetine, and citalopram, can also be used to treat PBA.

Behavioral Strategies

Eliciting the opposite emotion can help control their emotions. For example, during an episode of uncontrollable crying having someone tell a joke can stop the crying spell